AutismAutismLisa A. Tobler, MS

Reading Visual Impairments in Infancy, p. 178 Developmental Delay, p. 226 Autism, p. 289 ADHD, p. 387-388 Eating Disorders, p. 499 Depression, p. 534-535

Autism

Complex neurobehavioral disorder characterized by:

Impairment in social interaction Impairment in communication Restricted, perseverative

behaviors, interests, and activities

Diagnostic Criteria for Autistic Disorder (299.00)

To receive a diagnosis of Autism, a child must have at least 6 of the characteristics in the 3 areas (note minimums in each area) In one of the areas, onset must be

before age 3

Autism: DSM-IV Qualitative impairment in social

interaction as shown by at least two (2) of the following:•Marked impairment in nonverbal

behaviors• Failure to form developmentally

appropriate relationships• Lack of spontaneous seeking to share

enjoyment, interests, or achievements with other people

• Lack of social or emotional reciprocity

Autism: DSM-IV Qualitative Impairment in

communication as manifested by at least one (1) of the following: Spoken language or gesture Ability to initiate or sustain a conversation Stereotyped and repetitive use of

language or idiosyncratic language Lack of varied make-believe play or social

imitative play appropriate to developmental level.

Autism: DSM-IV Restricted repetitive and stereotyped

patterns of behavior, interests, and activities, as manifested by at least one (1) of the following: Stereotyped and restricted patterns of

interest Adherence to specific, nonfunctional

routines or rituals Stereotyped and repetitive motor

mannerisms Preoccupation with parts of objects

Causation? Genetic influences are the most

likely cause. Several research studies have been

published in the last 5 years pointing to genetic causation. Chromosome 16 was recently implicated.

Environmental factors Toxins?

Pervasive Developmental Disorders

Autistic Disorder (299.00) Asperger’s Disorder (299.80) Pervasive Developmental Disorder,

NOS (299.80) Rett Syndrome (299.80)

Autism Spectrum Disorders – confusing terminology

PDD vs. PDD, NOS Asperger’s vs. High Functioning

Autism Autism with or without mental

retardation Autism Spectrum Disorder (ASD)

DSM-IV-TR Criteria for PDD-NOS

Severe and pervasive impairment in the development of reciprocal social interaction along with Communication skills OR Presence of stereotyped behavior,

interests, and activities But criteria are not met for any other

PDD

Rett’s Disorder

CDC Statistics Occur in all racial, ethnic, and

socioeconomic groups Four times more likely to occur in

boys than in girls Parents who have a child with an

ASD have a 2%–8% chance of having a second child who is also affected.

What are the Symptoms? Atypical use of non-verbal behaviors

Eye gaze Gestures Facial expression

What are the Symptoms? Impaired Spontaneous seeking to

share enjoymentJoint Attention

What are the Symptoms? Restricted interests, stereotypies, and repetitive behaviors

What are the Symptoms? Atypical development of spoken language

Language regressionEcholaliaNot turning to name

What are the Symptoms? Atypical social and emotional reciprocity

Responding to name Orient toward people

Things to Note Does the child respond to parental attention Does the child watch the parent for social cues Does the child respond to his/her name

1992

Baseline year

0-30%

31-100%

101-300%

>1000%301-500%

1996

2002

0-30%

31-100%

101-300%

>1000%301-500%

Why the Increase in Cases? The increase in the rate of autism is

because of better diagnosing.• In 1999, the rate of autism was 1 in

10,000 births. • In 2009, it was 1 in 110 according to

the CDC. • This is a 5,000% increase in 10 years.

Ask Yourself??? If this increase is because of better

diagnosing, where are the thousands and thousands of adults with autism who should have received a diagnosis 10, 20 or 30 years ago?